Clinical Nutrition: Nutritionism

What is the significance of the 1977 Dietary Goals for the United States?

*First came out with a theory to "eat less beef and dairy" was the consensus by 30 different "experts regarding the lipid hypothesis *outrage by the dairy and meat industry led the statement to be replaced with "choose meats, poultry and fish that will reduce SATURATED FAT intake" *cannot say "eat less" as it is bad for the economy *nutrients were blamed as the problem instead of foods

what determines food quality

*caloric density *nutrient density *macronutrient composition *speed of digestion *addition of chemicals

what are the 2 ways described to determine dietary intake

1. food frequency questionnaire (FFQ): *ex. how much in the past month have you eaten chicken breasts *good to see patterns over the long term 2. 24 hour dietary recall *better option as you just recall everything you ate the day before

why might there be "bad science" when studying nutrition

1. losing the context of a healthy lifestyle which depends on : *where you live *access to fast food *who you hang out with *how much money you have 2. taking molecules from foods or adding them in doesn't seem to work either *antioxidants *fiber *fish oil **so maybe it depends more on what people are not eating rather than what they are

what are the 3 pernicious nutrition myths

1. nutrients matter more than food *reductionism *using supplements *don't rock the boat 2. need expert help 3. eat scientifically *we need to eat for energy and micronutrients at the base level

what problems arise when we wish to assess what people eat?

1. what way to we determine our dietary intake *we have good days and bad days in our diet 2. how accurate is the data reported *under report calories *over report exercise and then reports will correct for the faulty data

what are issues with the statement, "eat food, not too much, mostly plants"

1. what's food *calories? *energy? *ingrediant list? 2. whats too much *moderation? *BMR? *how to measure? 3. what's a plant? *potatoes are plants? *mostly is 80%- cannot eat enough calories to get what you need! *doesn't taste great

What is the zero sum relationship?

Eating more of one thing means eating less of another

1. Explain "correlation does not imply causation"?

In today's day and age, we are able to scour the internet looking for correlations between two variables that might look exactly the same, but not have anything to do with each other ex. per capita consumption of margine and divorce rates in Maine

what is the trend with eating occasions in the US

It has gone up from 3.5 to 5 meals a day as there has been an increase in snacking by the population and a decrease for the time between eating

what is orthorexia

Preoccupation with eating healthy food or correct eating based on your own subjective health and thoughts

what is the gold standard for studying nutrition

RCT

what is a really good cookbook

SALT FAT ACID HEAT- how to cook healthier foods, but still make them taste good

what is the nutrition transition

affluent cultures have an increase in chronic disease due to longevity (So risk for cardiovascular, cancer and types 2 diabetes are more common), otherwise you would die more from infectious disease also from having too many food choices, whcih leads to more confusion on what you should eat

What is the bliss point?

balancing fat, salt, and sweets to get happiness out of eating, *adding this to food is cheap *maybe it is trainable *think of ice cream or the taste of water

what are the primary energy sources

carbs and fats

Carbs vs. fat for energy

carbs- quick energy source due to glycolysis, can do without oxygen and the kreb's cycle , fats- slow energy source from B-oxidaion and the kreb's cycle

what are the two types of epidemiological trials

case control study observational study

what are RCTs designed for? do it work for nutrient reserach or diet reserach?

designed for drug studies but as far as nutrient and diet reserach it gets really messy as we cannot blind the patients as well and did the patients report their diet accurately

is nutrition a science or philosophy

philosophy accourding to Dr. Ratte

what is the rule of 1869

don't eat anything made past 1869- when margargine and flour/cereal was starting to be commercialized

what is the best way to get more fiber

eat more beans

what delays gastric emptying

eating more fat

how do we study nutrition

epidemiological trials RCTs

what is confirmational bias

finding a reserach article to support what you believe

what is a problem with nutrient density with food

food companies will add or remove nutrients as they see fit to sell their product

who benefits from nutrition confusion

food industry nutrional industial complex (researchers) journalists alternative practitioners

what is a way to measure the speed of digestion

glycermic index

what is caloric density? what macro has the high density

how many calories/gram are in food fats have the highest density- hence cutting fat will reduce your caloric intake

how can we bypass the fixed stomach

increaing the amount of food eaten- to increase satiety, but making sure it is the right foods compare 400 calories of oil to 300 calories of veggies

how should you cook your food

like your grandma!

what is the problem with the organic label

no pesticides/herbicides so is it better for you? *well what did they use instead to make it organic?

what is the problem with moderation

non-specific! SUBJECTIVE -its relative... who and what are you comparing moderation to? -opposes evolutionary "feast or famine"

what is parking lot science

observational bias or looking for something in the most obvious place such that nutrion has a big bias towards objective data that we can measure such as cholesterol, hypertension, weight or BMI

observational studies are both _________? what is a problem with them

prospective and retrospective selective bias

what are characteristics of the western diet

red meat refined grains processed food dairy sugar/salt/fat cheap/easy

what is a problem with case control studies

reporting bias- I state what I think I saw change in my patients

what is sort-of science

taking a hypothesis as facts since we cannot do an RCT, so take correlations and use them as facts since we cannot prove/test a theory

what is nutritionism

the idea that nutrients are more important than food

what is a problem with studies done by the women's health intiative

they used the FFQ, but this isn't a good option to look at the amount of calories consumed and the women in the study obviously lied about what they ate!

what is sensory specific satiety

too much of eating one type of food can turn you off of it aka something is "too sweet" for your bliss point FOOD industry uses this a lot for perfect consumer consumption

what is the hope to the western diet

we can adapt to many different diets based on our geography, reversing damage is possible

what do we do with the western diet

we tinker with it, but we don't overhaul it like maybe we should but adjusting nutrients and not questioning their value