Joan Plummer RD LMNT CDE 402 562 4462

Joan Plummer RD LMNT CDE 402 -562 -4462 jlplummer@columbushosp. org

� Foods that are thought to provide benefits beyond basic nutrition and may play a role in reducing or minimizing the risk of certain disease and other health conditions. � Examples include fruits, vegetables, whole grains, fortified foods and beverages and some dietary supplements.

� Nutrient Content claims- level of nutrient � Structure and function claim – effect on body � Dietary guidance claims – broad categories � Qualified health claim –developing claim for reduced risk backed by evidence � Health claim – CONFIRMED claim supported by significant evidence � Examples of FDA approved health claims: soluble fiber, whole grains , MUFA, Omega 3, calcium, potassium, stanols, soy protein, folate, vitamin D

� Health claim –may reduce risk of CHD and some type of cancers; supports maintenance of healthy blood glucose levels � Most Americans eat less than 1 serving /day � Excellent source of Vitamin E, B vitamins, fiber, zinc, iron and magnesium � Abundant in phytochemicals- polyphenols, phytoestrogens, cholesterol lowering phytosterols � Gut friendly insoluble fiber

� Look for the whole grain seal on the front of package � Check ingredient list to make sure whole grain is listed as first ingredient � Choose both soluble and insoluble fibers � Soluble includes those that are soluble such as oats � Insoluble include more fiber such as wheat fibers � Dietary guidelines recommend at least half of grains as whole grains

� Breakfast-include whole grain cereals, oatmeal, whole grain toast or English muffins; Add cooked quinoa and farro to pancake batter � Noon and evening meals- select whole grain breads, buns, bagels, pasta and brown rice. Add whole grains to soups, casseroles and mixed dishes � In baking add oats, bran and whole grain flours � Enjoy whole grains as snacks such as air- popped popcorn, granola, and 100% whole wheat or rye crackers

� Cracked wheat can be prepared in 5 -15 minutes. Use low sodium broth to enhance flavor � Lightly saute grains in a nonstick pan before adding the liquid to give them a nuttier toasted flavor � Try substituting wheatberries or farro for ground beef in your favorite chili recipes � Transform rolled oats into granola bars or cookies � Use whole grain tortillas in breakfast burritos

� Amaranth-gluten and wheat free. High in protein, calcium, iron and vitamin C. Easy to cook and adds texture. Add to salads, soups and cookies � Barley – high in fiber, magnanese, selenium and thiamin. Takes longer to cook but use in place of rice in stir-fry dishes, soups or casseroles. Cook a large batch and freeze for later use. Use hulled or hull-less , not pearl

� Bulgar- quick cooking form of whole wheat. High in manganese, fiber and protein. Add to soup, salads, and casseroles. � Farro- savory wheat. High in fiber and magnesium. Whole farro can be prepared as risotto or salad. Add to soups in place of rice. � Freekeh- young green wheat. Full of fiber, selenium, potassium and magnesium. Add to stir-fries, risottos and soups � Kamut- nutty flavor and high in fiber, protein, selenium and manganese. Use in soups, salads and in place of pasta.

� Millet-high in copper, manganese, phosphorus and magnesium. Used as a staple in Asia and Africa but in bird seed in the US. � Sorghum- high in antioxidants, neutral or slightly sweet flavor. Can easily be substituted for wheat flour in baked goods � Spelt- high in protein and fiber. Has a nutty flavor and can be substituted for rice or pasta � Teff-high in calcium(123 mg/cup) and other nutrients – ground into flour, sprinkle on vegetables or salads, mix with soups or casseroles

� Quinoa- complete protein. High in iron and phosphorus. Cooks quickly. Use as hot cereal with milk, fruit, and nuts; mix with greens, beans, herbs and spices, mix with a vinegarette as a side or salad; use in place of rice within a stirfry. � Challenge! Try one new whole grain each week and look for different recipes to keep it interesting.

� Maintain a healthy weight-obesity can negatively affect inflammation, the immune system and likely raises your risk for developing 13 types of cancer � Chronic inflammation occurs when the immune system attacks the body’s healthy cells leading to autoimmune disease � Eat fewer foods with added sugar and fats � Eat plenty of fruit and vegetables. Include more cherries and berries and cruciferous vegetables � Include more beans, which are linked with a lower cancer risk

� Limit saturated and trans fat � Choose more Omega 3 and Omega 6 fatty acids � Limit alcohol –Alcohol increases risk of cancers including mouth, throat (pharynx), voice box(larynx), esophagus, liver, breast colon and rectum. If you drink, limit it to no more than one drink daily for women and two for men.

� Omega 3 and Omega 6 fatty acids reduce inflammation and help regulate membrane function � Let fruits and vegetables make up half your plate. Include cherries and berries to reduce inflammation. Include more leafy greens. � Opt for plant-based sources of protein including beans, nuts and seeds � Choose whole grains instead of refined ones � Choose fatty fish such as salmon, sardines and anchovies to get Omega 3’s

� Season your meals with fresh herbs and spices. They are packed with antioxidants � Limit fats that turn on inflammatory processes such as saturated fat from meats, butter, cream sauces, fried foods and trans fat found in processed foods. � AHA guidelines recommends limiting saturated fat to no more than 7% of calories and 5 -6% for those with high LDL.

� Saturated tropical fats including palm, palm kernal oil and coconut oil increase LDL and risk for heart disease. Replace saturated with unsaturated. � Replacing fat with carb increases insulin production which signals the liver to manufacture more saturated fat � Increase longer chain Omega 3 found in fatty fish as well as shorter chain omega 3 found in flax seed and chia seed oils(keep cold)

� Flaxseed, grapeseed, and walnut oils are most susceptible to oxidation � Oxidized fatty acids have been shown to increase atherosclerosis � Store these oils in tightly capped containers in a cool , dark place or in frig � Omega 6 - Safflower, grapeseed, sunflower, wheat germ, corn, cottonseed, and walnut � 5 -10% of calories recommended � Omega 6 starts healing process by altering immune system; omega 3 take over

� Monounsaturated oils- reduce LDL cholesterol and TG and raise HDL cholesterol, decrease blood pressure � Examples –olive and canola oils � Modified oils such as high oleic safflower and sunflower oils � Both Omega 3 and Omega 6 are important � Saturated fat in cocoa(stearic acid) is thought to have a neutral effect on total and LDL cholesterol

� Monounsaturated oils more shelf stable � More high-oleic canola, high oleic sunflower and high-oleic safflower � Genetically modified soybean oil to include stearidonic acid- an Omega 3(health benefits? ) � Canola oil with marine DHA added � Genetically modified canola oil produce DHA (not on market yet)

� Highly saturated oil (lauric and myristic) which are hypercholesterolemic � Raise LDL and HDL – but no data that it is better than other saturated fats � More saturated fat than lard and beef tallow � Avoid highly processed and refined coconut oils

� Refined carbohydrates and fat may be equally harmful to heart health � Overall dietary patterns hold the key to health � Minimally processed foods are the best for heart health—vegetables, fruits, lentils, nuts, seeds and whole grains � Anthocyanin rich foods may provide CVD protection

� Mediterranean Diet—plant based with plenty of fruits, vegetables, whole grains, fish and moderate amounts of olive oil. Keeps aging brains sharp, improves cognitive function, memory and alertness � Eat cruciferous vegetables to help improve memory including broccoli, cabbage and dark leafy greens � Try a raw kale salad or collard greens in your next tortilla wrap. � Broccoli stir fry is another excellent option

� Dark berries, especially blackberries, blueberries and cherries are rich in anthocyanins and other flavonoids that may boost memory � Choose berries for a snack, mixed into cereal or baked into an antioxidant rich dessert � Omega 3 Fatty acids—esp DHA may help improve memory in young adults. DHA is the most abundant fatty acid in the brain � Seafood, and fatty fish including salmon, bluefin tuna, sardines and herring

� Include fish at least twice a week � Grill, bake or broil fish � Try salmon tacos with red cabbage slaw � Snack on sardines � Enjoy seared tuna on salad greens

� May help prevent CVD, cancer and boost cognitive function � Flavonoid family and phytochemcial found in plant foods � Most abundant in dark berries (black currants, elderberries, blueberries, strawberries) and their juices, and in red and purple grapes, red wine, sweet cherries, eggplant, black plums, blood oranges, and red cabbage � Protective mechanism against environmental stressors

� More found in darker color—more in red delicious apples than fuji apples; more in black raspberries than red; more in Concord grapes than red grapes � Women’s Health Study- one serving of blueberries or strawberries once per week significant reduction in cardiovascular death and CVD; Nurses Health Study- 3 servings per week reduced CVD risk by 34% � Possibly reduces arterial stiffness and blood pressure

� Act as antioxidants, activate detoxifying enzymes; may prevent cancer cell proliferation, induce cancer cell death; and have anti-inflammatory effects � Convincing studies in animals but human studies less promising � Choose a rainbow of colors in your fruits & veggies: red, orange/yellow, green, blue/purple because of the disease fighting benefits they provide

�½ cup serving � Excellent source of fiber, Vitamin A and C, potassium and folate � Protective effect of cranberry and blueberry consumption- certain cancers, cardiovascular disease such as atherosclerosis and ischemic stroke; and neurodegenerative disease � Improve insulin sensitivity and decrease type 2 diabetes, urinary tract disease and chronic inflammation � Improved short term memory loss and reversed some loss of balance and coordination

� Probiotics- promoters or the fuel for good bacteria which help support gastrointestinal health � Can stimulate a natural increase in good bacteria in the gut � May improve calcium absorption, alleviate IBS, prevent allergies, reduce postprandial glucose and insulin levels � Found in high fiber foods- recommended 2538 grams/day

� Foods with high amounts include chicory, garlic, leeks, onion, asparagus, and Jerusalem artichokes � Found in lesser amounts in bananas, whole wheat, yams and sweet potatoes � Increase fiber gradually and include plenty of fluid

� Friendly bacteria that helps ferment, decompose and digest the foods we consume � Lactobacillus and bifidobacterium boost the immune system and fight infection � May help with IBS and inflammatory bowel disease as well as may even help lower cholesterol� Found most commonly in Yogurt and Kefir. Make sure that it contains live and active cultures (has not been heated after production) 6 -8 oz yogurt or 4 oz kefir per day � New products- new yogurt flavors, single shot probiotic drinks and frozen Kefir bars

� Antioxidant --prevents oxidation of LDL cholesterol, reduce blood clotting, and improve widening of blood vessels in the heart. � Antioxidants in tea have been suggested to prevent cancer. Studies have been limited. � In Japan 1 cup of green tea/day was shown to decrease tooth loss. May be due to fluoridated water vs tea.

� Best detox is an overall healthful eating plan along with regular trips to the bathroom � Detoxification is the primary biochemical process for removing toxins by converting non-water soluble toxic compounds into water-soluble compounds that can be eliminated through urine, sweat, bile or feces � B vitamins, glutathione(the body’s main detoxifying antioxidant) and flavonoids have been shown to assist detoxifications

� Phytochemicals that induce detox enzymes can be found in cruciferous vegetables, onions and garlic � Fiber intake supports regular elimination, which is crucial for excreting toxins through the bile and stool. Brown rice fiber may be particularly helpful in eliminating fat soluble toxins. � Certain foods can impair and enhance liver function. Some experts recommend a short term detox of 1 -3 weeks based on eating healthful whole foods—vegetables, fruits, nuts, seed, beans, whole grains, herbs and spices, as well as eliminate foods that cause additional inflammation for some people such as refined sugar and certain food additives or preservatives

� FDA has sent ADI(Acceptable Daily Intake) for each artificial sweetener � The US sugar substitute intake is well below the ACI even for the heaviest users(dieters, adults and children with diabetes and women of childbearing age) � The ADI for a 150 lb adult is 17 cans of 12 oz soda or 97 packets of sweetener containing aspartame daily. � Foods may naturally contain the same chemicals as a sugar substitute and sometimes in greater quantities than the artificial sweetener

� Natural doesn’t always mean healthful � Honey- fructose & glucose, antioxidant, antimicrobial, soothing effects. Do not give to children less than 1 year. ¾ c = 1 cup sugar � Maple syrup – glucose and fructose— manganese and zinc, oxidants that reduce inflammation- may raise blood sugar more slowly ¾ cup = 1 cup sugar � Agave Syrup- treat nectar of agave plants – 90% fructose; 1 1/2 times sweeter than sugar. May cause liver disease? ¾ c = 1 cup sugar

� Stevia- South American shrub; 200 times sweeter than sugar; glucosides which can’t be metabolized in the human body- no calories, purified form GRAS 1: 1 � Monk fruit- south China-200 X sweeter than sugar-glucoside-antioxidant 1: 1 � Coconut palm sugar-70 -80% sucrose- nutty flavor; 1: 1 � Date sugar-ground dates- potassium, calcium and antioxidant-doesn’t melt 2/3 c for 1 cup sugar

� Fructose- metabolized exclusively in the liver; liver turns into fat which may lead to fatty liver, increases risk of diabetes and LDL cholesterol � AHA recommends no more than 100 kcal from sugar for women and 150 kcal for men � Satisfy sweet tooth with things like fruit � Need to go back to the idea that sugar is a treat

� Organic- forbid use of synthetics fertilizers and pesticides, sewage sludge, irradiation and genetic engineering to grow fruits, nuts, vegetables and grains � Nutritional quality is what matters � Choose organic produce in season � Buy from farmers market and community supported organic programs � Don’t waste money on purchasing organic junk foods! � Buy in bulk and what’s on sale

� Dirty dozen- apples, celery, cherry tomatoes, cucumbers, grapes, hot peppers, nectarines(imported), peaches, potatoes, spinach, strawberries and sweet bell peppers � Clean 15 - Asparagus, avocados, cabbage, cantaloupe, sweet corn, eggplant, grapefruit, kiwi, mangos, mushrooms, onions, papayas, pineapple, sweet peas(frozen), sweet potatoes

� Wash your hands for 20 seconds with soap and water before preparing fresh produce � Cut away any damaged or bruised area before preparing or eating � Wash produce with large amounts of cold or warm running tap water and scrub with a brush � Wash produce before you peel it � Dry produce with a clean cloth/paper towel � Throw away the outer leaves � Trim the fat and skin from meat. Some residues concentrate in animal fat

� Eating whole foods in their least processed state � Lots of fruits and vegetables, nuts and seed � High in fiber, antioxidants, vitamins, minerals and good fats � Consumers often don’t trust the scientists but what they read on the internet and hear about today’s buzzwords � Food scientists tap into what people like to eat and still keep food safe, nutritious, affordable, shelf stable, and accessible.

� Whole food bars � Fruit and vegetable pouches � Fresh take on chips � Convenient, novelty and fun

� Soy is a high quality source of protein packed with vitamins, minerals, fiber, Omega 3 and 6 fatty acids. Rich in isoflavones. Best sources are soymilk, tofu, soynuts, tempeh, miso and edamame � Myths � All soy products are made from GMO’s (soymilk, tofu, tempeh, edamame, some meat alternatives and nutrition bars are not GMO) Eating soy increases breast cancer risk—no association found and may even lower risk of breast cancer recurrence with moderate consumption

Soy causes feminization in men- no clinical evidence � Soy phytoestrogens inhibit thyroid functiononly very high doses may induce clinicial hypothyroidism in minority of patients. Decreases absorption of replacement thyroid hormone so take on empty stomach � Soy-based infant formula can disrupt growth and reproductive development- no clinical evidence �

� Gluten should be avoided. No clinical evidence that it should be avoided except in celiac disease and non-celiac gluten sensitivity � Speed up your metabolism- often involve specific foods such as refined sugar, wheat, soy, caffeine, alcohol, and artificial sweeteners – no clinical evidence. Body recognizes nutrients not individual foods � Timing-must eat 6 -7 meals and snacks. May add up to calories/weight gain. Hunger and fullness best cues for meal spacing

� Confuse your body to lose weight with different foods to confuse yourmetabolism— no clinical evidence � Food intolerances equal weight gain. Proposes foods that may trigger inflammation and lead to weight gain such as gluten, dairy, soy, corn, peanuts, eggs, sugar and artificial sweeteners—no credible research � Food additions cause weight gain—Proposes curbing food crazing restores the brains mood and appetite and key to weight loss-no clinical evidence.

� Prioritize what’s important � Buy in bulk � Buy in season and save � Search for sales � Utilize private store brands � Watch the waste � Smart shopping mobile app www. supermarketguru. com www. eatright. org