What Is A Healthy Diet?

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What Is A HealthyDiet and Metabolism Diet?USDA DietaryRecommendationsHigh Fat FoodsOther High Fat FoodsLow-Fat FoodsHistory: Before 1970Before 1970 (cont.)History: 1960’sResultMy PlateSuccess ofRecommendationsDiabetes TrendsCorrelation does NOTmean CausationCriticism of DietaryGuidelinesProteinDiet and CholesterolDr. Clarke EarleyKent State University at StarkMolecules of LifeWhat Is A Healthy Diet?Western DietDiet StudiesExerciseDr. EarleyMolecules of Life – 1 /USDA Dietary RecommendationsDr. EarleyMolecules of Life – 2High Fat FoodsFor adults (19 years or older), % Calories should* be: Carbohydrates 45-65%Protein 10-35%Fats 20-35%*USDA Dietary Guidelines for Americans, 201058% Calories from FatDr. EarleyMolecules of Life – 3 /Other High Fat FoodsDr. EarleyDr. EarleyMolecules of Life – 4Low-Fat Foods21% Calories from Fat77% Calories from Fat52% Calories from Fat82% Calories from Fat27% Calories from Fat0% Calories from Fat34% Calories from FatMolecules of Life – 5 /Dr. EarleyMolecules of Life – 6

History: Before 1970Before 1970 (cont.)1951 textbook “The Practice of Endocrinology” summarized conventional,well-accepted beliefs of the time. This had been accepted for at least 100 years.The 1951 textbook “The Practice of Endocrinology” also made the followingrecommendations (similar recommendations made by Stanford Univ. School ofMedicine, Harvard Medical School, Children’s Memorial Hospital in Chicago, andCornell Medical School).Foods to avoid: Bread, and everything else made with flour .Cereals, including breakfast cereals and mil puddingsPotatoes and all other white root vegetablesFoods containing much sugarAll sweets .You may eat as much as you like of the following foods: Dr. EarleyMolecules of Life – 7 /History: 1960’sMeat, fish, birds.All green vegetablesEggsCheeseFruit (if unsweetened), except bananas and grapesDr. EarleyMolecules of Life – 8ResultHypothesis: Diets high in fat cause increase in risk for heart disease.This hypothesis was NOT based on medical studies, but did lead to new studies(more on this later).At this time it was known that: Diets high in fat and low in carbohydrates are effective for weight loss.Extremely overweight individuals have increased risk of heart disease.1992 USDA Food PyramidUSDA U.S. Department of Agriculture1956: Four Food Groups lobbied/promoted by Diary Council2005 MyPyramid very similar to 1992 Food PyramidDr. EarleyMolecules of Life – 9 /My PlateDr. EarleyMolecules of Life – 10Success of RecommendationsGross, L.S.; Li L.; Ford, E.S.; Liu, S. Am. J. Clinical Nutrition, 2004, 79(5), 774-7792011 My Plate1956 - Four Food Groups1992 - Food Pyramid2005 - My PyramidCurrent recommendationsDr. EarleyMolecules of Life – 11 /Dr. EarleyMolecules of Life – 12

Diabetes TrendsCorrelation does NOT mean CausationGross, L.S.; Li L.; Ford, E.S.; Liu, S. Am. J. Clinical Nutrition, 2004, 79(5), 774-7791956 - Four Food Groups: Carbohydrates Meat, Dairy, Fruits & Vegetables1992 - Food Pyramid: Carbohydrates at base of pyramid2005 - My Pyramid: Carbohydrates still largest group2011 - Newest Guidelines: 45-65% of Calories from CarbohydratesDr. EarleyMolecules of Life – 13 /From tylervigen.com/spurious-correlationsDr. EarleyMolecules of Life – 14Criticism of Dietary GuidelinesProteinThe 2010 Dietary Guidelines (DG) have been criticized in scientific literature(Nutrition, 26 (2010) 915-924.) Major criticisms include:As an example of these types of problems, consider the 2010 Dietary Guidelines (DG)recommendations on protein. Strong recommendations based on weak evidence.American diets generally “fall within recommended ranges”, but health problemsgrowing.Report dismisses low-carbohydrate diets as not effective and harder to maintain,but literature does NOT support this.DG recommends low saturated fat, but a 2010 analysis of literature found nocorrelation between high intake of saturated fat and heart disease.Recommendations on limiting salt intake not consistent with scientific studies.Dr. EarleyMolecules of Life – 15 / DG report emphasizes (for 1st time) importance of protein.DG report states that animal sources provide the highest-quality protein.DG report concludes that the evidence is “moderate, limited, insufficient andinconsistent” on any relationship between animal protein consumption andnegative health outcomes.The DG report then goes on to recommend Americans shift to more “plant-based” dietand “consume only moderate amounts of lean meats, poultry, and eggsDr. EarleyMolecules of Life – 16Diet and CholesterolWhat Is A Healthy Diet? Western DietHungry Planet - Image 1Hungry Planet- Image 2Deficiencies in WesternDietChanges in WheatAdded Sugar andObesityDanger of Added SugarsTypes of Added FatUse of Soybean OilResults of ChangingFatsWestern DietDiet StudiesExerciseGraph shows blood cholesterol levels for men and women with above average (red)and below average (blue) cholesterol intake. Based on data from Framingham study,one of the largest health studies ever.Dr. EarleyMolecules of Life – 17 /Dr. EarleyMolecules of Life – 18

Hungry Planet - Image 1Hungry Planet- Image 2(Hungry Planet by Peter Menzel)Dr. EarleyMolecules of Life – 19 /Deficiencies in Western DietDr. Earley(Hungry Planet by Peter Menzel)Molecules of Life – 20Changes in WheatModern farming practices and changes in wheat have led to a decrease in mineralcontent.Dr. EarleyMolecules of Life – 21 /Added Sugar and ObesityDr. EarleyMolecules of Life – 22Danger of Added SugarsJAMA Intern Med: 2014; 174(4), 516Years1988-19941999-20042005-2010% Calories fromAdded Sugar15.7%16.8%14.9%% Calories fromAdded Sugar 10%10.0-24.9% 25.0%Hazard Ratio(CVD Mortality)1.001.302.75Excessive intake of added sugar appears to be linked to the development of high bloodpressure, increased triglycerides (blood fats), low HDL (good) cholesterol, fatty liverproblems, as well as making insulin less effective in lowering blood sugar.Am J Clin Nutr: Oct. 2007; 86(4), 899Dr. EarleyMolecules of Life – 23 /Dr. EarleyMolecules of Life – 24

Types of Added FatUse of Soybean OilAuthority NutritionAuthority NutritionEstimated that soybean oil provided 7% of calories in the U.S. diet in 1999.Shift from saturated fats to unsaturated oils.Dr. EarleyMolecules of Life – 25 /Dr. EarleyMolecules of Life – 26Results of Changing FatsAm J Clin Nutr: May 2011; 93(5), 950What Is A Healthy Diet?Western Diet Diet StudiesEating Less (or More)Low Carb DietsTwo DietsSubject & Diet DetailsResultsConclusionsUnanswered QuestionsDiet StudiesExerciseLinoleic Acid is an Omega-6 fatty acid. It appears that this is replacing the essentialOmega-3 fatty acids. May be linked to cardiovascular disease, cancers, arthritis,asthma, . (See “Fat and Cholesterol” lecture notes).Dr. EarleyMolecules of Life – 27 /Dr. EarleyMolecules of Life – 28Eating Less (or More)Low Carb DietsIf you were preparing to eat as much as you could for a dinner, how would youprepare?Paleo Diets, the Atkin’s Diet, Protein Power Plan, and other related diets require: Don’t eat all dayExercise If you want to lose weight, what steps should you take?Dr. Earley Very low carbohydrate intakeHigh fat intake (for fuel)High protein (to avoid muscle degradation)Claim is that we consume too much simple sugar, which gives rise to diabetes.These are very close to dietary recommendations before 1960’s.American Heart Association warned that these diets can be dangerous.Molecules of Life – 29 /Dr. EarleyMolecules of Life – 30

Two DietsSubject & Diet DetailsCompare two diets reported in medical literature.1. Low Fat: McMillan-Price et al., Archives Internal Medicine, Vol. 166, July 24,2006A 12-week study of “129 overweight or obese young adults”.2. High Fat: Yancy et al., Nutrition and Metabolism, Vol. 2(34), 2005.A 16-week study of “28 overweight participants with type 2 diabetes”.Dr. EarleyMolecules of Life – 31 /ResultsNumberMen/WomenAgeWeight (kg)Low Fat329/2330.587High Fat2120/156.0131Carbs (g)Fat (g)Protein (g)Calories%Calories from Fat2173873154022%4198108148060%Dr. EarleyMolecules of Life – 32ConclusionsWeight (kg)CholesterolHDL (good)LDL (bad)HDLLDLTriglyceridesGlucoseDr. EarleyLow Fat-4.8 (-5.5%)-0.18 (-3.8%) 0.03 ( 2.6%)-0.17 (-5.9%)0.403 0.440-0.05 (-3.6%)-0.06 (-1.2%)ResultsHigh Fat-8.7 (-6.6%)-0.07 (-1.5 %) 0.07 ( 7.6%) 0.26 ( 10.4%)0.366 0.357-1.12 (-41.6%)-1.51 (-16.6%) Molecules of Life – 33 /Low fat diet can lower cholesterol and improve HDLLDL ratio.High fat diet can significantly lower blood triglycerides.High fat diet can significantly lower blood glucose.Dr. EarleyMolecules of Life – 34Unanswered QuestionsWhat Is A Healthy Diet?QuestionsWestern Diet Is 12-16 weeks long enough?– Diet StudiesEx. A 2010 study found “During the first six months of the study, the low-fatdieters had greater reductions in LDL, or ’bad,’ cholesterol, but the differencesdid not persist over time.”Are these samples representative?Do differences in sex matter with diet?Do differences in age matter with diet?Which (if either) is more important: Cholesterol or Triglycerides?Dr. EarleyMolecules of Life – 35 / ExerciseEnergy ExpendituresExercise and CaloriesProblems with ExerciseUSDA ConsumerFriendly TipsMy OpinionDeficiencies in WesternDietAddressing Deficienciesin Western DietDiet Advice - OPINIONDoes Diet Matter?Dr. EarleyExerciseMolecules of Life – 36

Energy ExpendituresExercise and CaloriesActivityAerobics (vigorous)Basketball (vigorous)Bicycling (11 mph)Jogging (10 min/mile)Running (7 min/mile)Swimming (fast)Walking (20 min/mile)Calories/min (180 lb person)111591418135One pound of fat 3500 CaloriesIf 180 pound person runs 3 miles a day, 7 days a week he/she will use:(7 min/mile) * (21 miles) 147 minutes(18 Calories/min) * (147 minutes) 2646 CaloriesBut only 1/3 of these are due to fat.2646 / 3 882 Calories of fat per weekTo lose 1 pound fatTaken from ACS Textbook “Chemistry in Context”, 3rd Edition, Table 11.6 (p. 441)Dr. EarleyMolecules of Life – 37 /(3500 Calories) / (882 Calories/week) 4 weeksExercising this much will allow you to lose 1 pound of fat per month!Dr. EarleyMolecules of Life – 38Problems with ExerciseUSDA Consumer Friendly TipsExercise is often touted as the best way to lose weight. However, Very few (if any) controlled medical studies have shown exercise to be effective atweight loss.Direct calorie burning results in very little weight loss (see above).Increased activity generally results in increased appetite. Enjoy your food, but eat lessAvoid oversized portionsMake half of your plate fruits and vegetablesSwitch to fat-free or low-fat (1%) milkCompare sodium in foods like soup, bread, and frozen meals - and choose thefoods with lower numbersDrink water instead of sugary drinksUSDA Dietary Guidelines for Americans, 2010Dr. EarleyMolecules of Life – 39 /My OpinionDr. EarleyMolecules of Life – 40Deficiencies in Western DietUSDA Dietary Guidelines - Tips Enjoy your food, but eat lessAvoid oversized portionsDifficult on a low-fat diet.Make half of your plate fruits and vegetablesYesSwitch to fat-free or low-fat (1%) milkWhy?Compare sodium in foods like soup, bread, and frozen meals - and choose thefoods with lower numbersUnless you have high blood pressure, Why?Drink water instead of sugary drinksDefinitelyDr. EarleyMolecules of Life – 41 /Dr. EarleyMolecules of Life – 42

Addressing Deficiencies in Western DietDiet Advice - OPINIONMost of this information from Dr. Terry Wahls Greens: Vitamins A, B, C, K and MineralsColors: Flavonoids, polyphenols (antioxidants)Wild Fish: Omega-3 fatty acidsOnions, Garlic, Leeks: Sulfur (for brain, mitochondria, toxic removal)Organ Meats: Vitamins, Minerals, Coenzyme QSeaweed: Iodine“Biggest” problemsToo much added sugarNot Enough Omega-3 FatsWheat SensitivityVitamin/Mineral DeficienciesSolutionReduce/Eliminate soda - Reduce processed foodFish, Grass-fed milk, . SupplementsReduce/Eliminate WheatVegetables and FruitsI do NOT see problems with fat (especially saturated fats), cholesterol, and/or salt.Disclaimer: I am not a medical doctor.Dr. EarleyMolecules of Life – 43 /Does Diet Matter?For at least some people, the answer is definitely yes.Dr. Terry Wahls has Multiple Sclerosis (MS) and was confined to a wheelchair. Basedon a review of the medical literature, she changed her diet and is now physicallyactive. Her diet includes: 9 cups vegetables & fruit each dayAdding essential (omega-3) fatty acidsEliminating glutenA comment on the WebMD site cautions against using diet to treat MS because it hasnot been proven. (However, this article also recommends cutting out saturated fats toprevent heart disease).Dr. EarleyMolecules of Life – 45 /Dr. EarleyMolecules of Life – 44

Jogging (10 min/mile) 14 Running (7 min/mile) 18 Swimming (fast) 13 Walking (20 min/mile) 5 Taken from ACS Textbook “Chemistry in Context”, 3rd Edition, Table 11.6 (p. 441) Exercise and Calories Dr. Earley Molecules of Life – 38 / One pound of fat 3500 Calories If 180 pound person runs 3 miles a day, 7 days a week he/she will use:

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