Friday, April 24, 2015

Just Two Weeks of Drinking Sugar-Sweetened Beverages May Increase Risk of Heart Disease

I previously wrote an article about how sugar-sweetened beverages may decrease the body's stress response. Now, there is another study out suggesting that drinking sugar-sweetened beverages may increase the risk of heart disease. It is important to keep in mind that how the studies were conducted and if there is other research out there to back it up. It is also important to remember moderation is key when it comes to what we eat and drink.

This study is the first to show a direct dose-dependent relationship between the amount of added sugar consumed in sugar-sweetened beverages and increases in specific risk factors for cardiovascular disease. There are other studies that show an increase in sugar-sweetened beverages correlates with an increase in cardiovascular disease. There were 85 participants both men and women between the ages of 18-40 years old who were divided into four different groups. The study followed these participants for 15 days while they consumed sugar-sweetened beverages with high-fructose corn syrup in 0 percent, 10 percent, 17.5 percent, and 25 percent of total daily calorie requirements.  It is important to note that the 0 percent group was the control group and they were given aspartame, an artificial sweetener.

At the beginning and end of the study the participants had their blood drawn hourly to monitor lipoproteins, triglycerides, and uric acid, all markers associated with cardiovascular disease. The study found that the higher the level of high-fructose corn syrup the higher the blood levels of lipoproteins, triglycerides, and uric acid. The study also found that men's blood levels increased more than the women's blood levels. The blood levels were independent of body weight gain. There is more research needed in this area, especially a longer time frame, since most people consume sugar-sweetened beverages regularly.

Kimber Stanhope et al. A dose-response study of consuming high-fructose corn syrup–sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adultsAm J Clin Nutr, April 2015 DOI:10.3945/ajcn.114.100461


Tuesday, April 21, 2015

Green Tea and Apples May Protect Health

New research may suggest that compounds in apples and green tea may help to protect our health. Other dietary studies have shown that consuming diets high in fruits and vegetables reduces the chance of developing chronic diseases like heart disease, diabetes, and cancer. There could be multiple reasons for this. One reason may be the fact that fruits and vegetables contain polyphenols, which may help to protect our health. 

In this study it was shown that polyphenols that are in green tea and apples block a signaling molecule called VEGF, which can trigger atherosclerosis in the body and anti-cancer drugs. In the body VEGF drives blood cell formation by a process called angiogenesis. Angiogenesis is a major contributor to cancer progression and the formation of plaque and plaque rupture, which can cause a heart attack or stroke. Using cells that were from human blood vessels, the researchers found that low levels of EGCG the polyphenol in green tea and procyanidin from apples stopped an important signaling function of VEGF. If this mechanism were to happen in the body as well, polyphenols will be very helpful in protection of our health. 

The polyphenols also activated another enzyme that makes nitric oxide in the blood. Nitric oxide helps to widen blood vessels and prevent damage. This was not expected. VEGF also activates nitric oxide while, anti-cancer drugs try and reduce nitric oxide. This could potentially lead to an increase in hypertension with some people. More research is needed to determine if this mechanism happens in the body and to what extent nitric oxide is being activated and reduced. 

Christina W. A. Moyle, Ana B. Cerezo, Mark S. Winterbone, Wendy J. Hollands, Yuri Alexeev, Paul W. Needs, Paul A. Kroon. Potent inhibition of VEGFR-2 activation by tight binding of green tea epigallocatechin gallate and apple procyanidins to VEGF: Relevance to angiogenesisMolecular Nutrition & Food Research, 2015; 59 (3): 401 DOI: 10.1002/mnfr.201400478


Monday, April 20, 2015

Nutrition Recommendations to Prevent Kidney Stones: Realistic Dietary Goals and Expectations

There is no standard diet to prevent kidney stones because there are various types of kidney stones and risk factors associated with each one of them. In order to provide individualized nutrition therapy, dietitians need to look at the medical history, current/past dietary pattern, type of stone, 24-hour urine parameters, and medications.

The followings are some types of kidney stones:
·      Calcium oxalate stones (which is caused by: high urinary calcium excretion, high urinary oxalate excretion, low urinary citrate/magnesium excretion or low urine volume.
·      Calcium phosphate stone (which is caused by: high urinary calcium excretion, low urinary citrate excretion, high urine pH, or low urine volume)
·      Uric acid stones (which is caused by: genetic problem, or some diseases such as leukemia, lymphoma, multiple myeloma, and sickle cell disease. These might result in high urinary uric acid excretion, low (acid) urine pH, or low urine volume)
·      Cystine Stones (occur genetically where the kidney is unable to filter the cystine. May need to control the methionine in diet)

Dietitians need to check for excessive sodium intake, high acidic food, excessive calcium intake, magnesium deficiency, or medications that causes hypocitraturia. Dietitians also need to check contributing health conditions that might affect urine PH such as obesity or insulin resistance. Weather the stones resulted from dietary factor or not, diet plays important role in treating/preventing the occurrence/recurrence of kidney stones. It is essential for the RD to know the stone composition and the associated causes and risk factors.


Penniston, K. L. (2015). Nutrition Recommendations to Prevent Kidney Stones: Realistic Dietary Goals and Expectations. In Kidney Stone Disease (pp. 187-200). Springer International Publishing.

Sunday, April 19, 2015

Eating Disorders and GI Symptoms- Understanding the Link Between Them and How to Treat Patients

The lifetime prevalence of a woman developing an eating disorder is about 6%, and a man developing an eating disorder is about 3%. Yet, it was found that 98% of those with eating disorders experienced gastrointestinal issues as a complication of the disease and 50% were diagnosed with irritable bowel syndrome. The most common gastrointestinal issues were seen to be heartburn, bloating, constipation, dysphagia, and anorectal pain.
These are all facts that you could find just about anywhere. What was so interesting about this article is that it really talks about the connection into all the causes of GI distress stemming from eating disorders. For example, although the actual eating disorder can be the primary cause of a gastrointestinal disease such as irritable bowel syndrome, this article explains that the primary cause is frequently anxiety and obsessive compulsive tendencies that put stress on the body that eventually leads to GI issues.
This article explains that it is the dietitians job to find the triggers that will cause this anxiety and distress and try to keep it from happening the first place. They suggest using the following steps:

1) Review family and personal history of GI concerns. Clarify whether the patient's symptoms existed before or after the start of the eating disorder.

2) Identify specific GI symptoms.

3) Screen for eating disorder behaviors.

4) Consider additional causes of GI symptoms such as stress and medication use.

5) Refer patients to gastroenterology for further evaluation


Scarlata, K., & Anderson, M. (2014). Eating Disorders and GI Symptoms- Understanding the Link Between Them and How to Treat Patients. Today's Dietitian, 16(10), 14-14.

Friday, April 17, 2015

Nutrition Services for Individuals with Intellectual and Developmental Disabilities and Special Health Care Needs

Intellectual and developmental disability (IDD) affects about 1-3% of adults and children in the United States. Intellectual function and adaptive behavior will be limited which affects many aspects of daily life such as self-care, mobility, self-direction, and learning and language skills. Children and youth with special health care needs (CYSHCN) require special health service as a result of increase risk of emotional, behavioral, physical or developmental conditions. It was estimated that during the year of 2009-2010, there was 11.2 million children under this category.

Prevention and early treatment is essential in reducing the high cost of health care services that results from several chronic conditions that IDD and CYSHCN individuals may develop over their life span such as obesity, diabetes mellitus and hypertension. Many of these conditions are nutrition-related, therefore, the role of the RDN and the NDTR as part of the comprehensive care process is considered vital. 

The followings are nutrition-related issues that RDNs need to pay attention to when assessing individuals with IDD or CYSHCN:

  • ·      Oral health care: problems may include gingivitis, periodontitis, and caries. The type of diet/texture will be affected.
  • ·      Mealtime assistance: cooperation with the speech language pathologists and occupational therapists is important so that he RDN can estimate the best feeding plan (oral or enteral) for the patient according to the level of assistant he/she needs.
  • ·      Dysphagia: monitor signs and symptoms of dysphagia (food refusal, frequent vomiting, respiratory distress as a meal progresses, frequent gagging and/or coughing…), in addition to weight record/growth records for significant weight change.
  • ·      Enteral feedings: RDN will use enteral feeding when it is not possible to maintain optimum nutrition and hydration status through oral intake.

By working closely with the interdisciplinary team and the caregiver, the RDNs and the NDTRs will be able to assess the special needs of each of the IDD and CYSHCN individuals. Also, they will be able to provide individualized nutrition care plan. This will have impact on the development and growth of this population and will help to treat/reduce further complication of the nutrition-related health condition.


Ptomey, L. T., & Wittenbrook, W. (2015). Position of the Academy of Nutrition and Dietetics: Nutrition Services for Individuals with Intellectual and Developmental Disabilities and Special Health Care Needs. Journal of the Academy of Nutrition and Dietetics, 115(4), 593-608.

Thursday, April 16, 2015

Sugar Sweented Beverage May Supress Body's Stress Response

There was a recent study that looked at the relationship between sugar sweetened beverages and non-sugar sweetened beverages and how the body responds in respect to stress. This double-masked diet intervention studied the effects of consuming sugar and aspartame-sweetened beverages. This study was conducted on 19 women between the ages of 18-40. Eight women were assigned to consume the aspartame-sweetened beverages, while eleven women were assigned to consume sugar-sweetened beverages for twelve days. Over the twelve day period the women were to consume one of the assigned beverages at breakfast, lunch, and dinner. The participants were instructed not to consume any other sugar-sweetened beverages including fruit juice. 

For three and a half days before and after the study the women consumed a low fat diet and stayed at the UC Davis Clinical and Translational Science Center's Clinical Research Center. Before and after the twelve day intervention the women would take a math test and then undergo an MRI to gauge the brain's stress response. The participants also provided saliva samples to measure levels of cortisol, a hormone that is made by the adrenal gland that is essential in stress response. 

The researchers found that the women who drank the sugar-sweetened beverages had lower levels of cortisol after the math test, compared to the women who drank the aspartame-sweetened beverages. Also, the women who drank sugar-sweetened beverages had more activity in the hippocampus, an area of the brain that is involved in memory and responds to stress, compared to the women who drank the aspartame-sweetened beverages. However, there is concern that sugary beverages such as pop and juice are linked with obesity rates. According to the CDC half of the U.S. consumes sugar-sweetened beverages on any given day. 

This study is the first evidence that sugar and not aspartame may relieve stress in humans. There is more research needed in this area and this is a start. 

Matthew S. Tryon, Kimber L. Stanhope, Elissa S. Epel, Ashley E. Mason, Rashida Brown, Valentina Medici, Peter J. Havel, Kevin D. Laugero. Excessive Sugar Consumption May Be a Difficult Habit to Break: A View From the Brain and BodyThe Journal of Clinical Endocrinology & Metabolism, 2015; jc.2014-4353 DOI: 10.1210/jc.2014-4353


Tuesday, April 14, 2015

The Association of Fruit and Vegetable Intake and Oxidative Stress

Over production of free radicals may result in damage of DNA and bodily lipids and proteins. Excessive oxidative stress is also associated with infertility, impaired follicular growth, endometriosis, spontaneous abortion, increased risk for low-birth weight children, and several chronic diseases. Fruits and vegetables (F/V) contain several anti-oxidant compounds that assist in alleviating oxidative stress, thus making them an essential component of a healthy diet. This study had the goal of determining if consuming five servings of F/V per day has an effect on oxidative damage and anti-oxidant defense biomarkers. The participants of the study included 258 premenopausal women. Dietary intake of the participants was determined by food frequency questionnaires and 24 hour diet recalls. Lab values measured in this study included plasma concentrations of F2-isoprostane, 9-hydroxyoctadecadieneoic acid, 13-hydroxyoctadecadieneoic acid, erythrocyte activity of superoxide dismutase, glutathione reductase, glutathione peroxidase, and blood micronutrient concentrations. The results of the study showed that meeting the recommendation of F/V intake is associated with decreased oxidative markers and increased anti-oxidant markers.

The conclusions obtained through this study are fairly straight forward, though it helped to provide support to the current dietary recommendations. Dietitians should be knowledgeable in the risks of having a diet low in F/V as well as the benefits associated with consumption of these foods.


Rink, S. M., Mendola, P., Mumford, S. L., Poudrier, J. K., Browne, R. W., Wactawski-Wende, J., ... & Schisterman, E. F. (2013). Self-report of fruit and vegetable intake that meets the 5 a day recommendation is associated with reduced levels of oxidative stress biomarkers and increased levels of antioxidant defense in premenopausal women. Journal of the Academy of Nutrition and Dietetics, 113(6), 776-785.