Eating a la Mediterranean? No need to hold the fat!

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A new study published in the Annals of Internal Medicine has found that a healthy diet is one that can contain a lot of fat.

This large systematic review looked at the Mediterranean diet and selected adherents who had no restrictions on their fat intake. It turns out that an eating pattern of this type can reduce risk for breast cancer, diabetes and cardiovascular disease when compared to other diets.

There’s no clear definition of exactly what constitutes a Mediterranean diet. The diet is plant-forward with minimal amounts of animal foods, an emphasis on fish, whole foods, fruits and vegetables and healthy fats from olive oil, nuts and avocados. There is moderate amount of red wine and importance placed on enjoying foods with others.

For more information about the Mediterranean diet and its potential health benefits, check out the Oldways Mediterranean Diet page available here.

Dietary Guidelines: What’s New & Best for You?



January 7, 2016 marked the release of the new Dietary Guidelines for Americans 2015 – 2020. Since the introduction of the dietary guidelines in 1980 15% of Americans were classifies as obese, now more than 35 years later this statistic has ballooned to 35% of all Americans. Obviously the intended messages of the guidelines are not impacting our society in the way they were intended. So what are the new dietary guidelines, how are they different, and how can they impact change in our society?


  1. Follow a healthy eating pattern across the lifespan
  2. Focus on variety, nutrient density, and amount
  3. Limit calories from added sugar and saturated fats and reduce sodium intake
  4. Shift to healthier food and beverage choices
  5. Support healthier eating patterns for all

How they are different:

The new dietary guidelines are much broader to allow focus on small changes in the diet instead of letting individual food groups and nutrients consume you. The key component is emphasis on a healthy eating pattern that is calorically appropriate to help support a healthy body weight and reduce risk of chronic disease. Shifts in personalized food and beverage choices need to be made to achieve a healthy eating pattern and increase nutrients of concern such as potassium, calcium, Vitamin D, and fiber.


A new specific limit on added sugars to less than 10% of calories is highlighted in the new guidelines. Paying attention to identifying sugary beverages in your diet and limiting these can make a huge impact on eliminating excessive calories in your diet and may even aid in trimming up your waistline.


There has also been a removal of a specific limit on dietary cholesterol. Evidence shows there is no relationship between dietary and serum cholesterol. It is now recommended that Americans eat as little dietary cholesterol as possible.

The new guidelines offer an adaptable framework to allow food choices that fit in your budget and align with personal and cultural preferences. Benefits of these new guidelines enable you to choose a diet that is right for you.

Below are key recommendations to consider when implementing a heathy eating pattern:

  • Include a variety of vegetables – dark green, red and orange, legumes (beans and peas), and starchy
  • Focus on fruits, especially whole
  • Grab grains, at least half should be whole grains
  • Choose fat-free or low-fat dairy (milk, yogurt, cheese, fortified soy beverages)
  • Implement in your diet a variety of protein foods (seafood, lean meats and poultry, eggs, legumes, nuts, seeds, and soy products)
  • When possible, choose oils as fat sources
  • Limit saturated fats, trans fats, added sugar, and sodium
  • Consume less than 10 percent of calories per day from added sugar
  • Consume less than 10 percent of calories per day from saturated fats
  • Consume less than 2,300 mg per day of sodium
  • Limit alcohol to one drink per day for women, and two drinks per day for men
  • Meet the Physical Activity Guidelines for Americans (at least 150 minutes of moderate exercise)

Simple solutions to make these recommendations work for YOU:

  • Make a switch to replace sugary desserts with fruit instead
  • Limit soda or energy drinks to one per day
  • Tailor portion sizes to fit your needs
  • Substitute medium or high fat protein for lean choices each day
  • Cook more often at home to limit added sugar and sodium
  • Make a conscience effort to increase daily activity
  • The Mediterranean, vegetarian, and DASH diets are all examples of healthy eating patterns

Impact of society in order to implement change:

With the new dietary guidelines there is a shift toward the idea that everyone plays a role in supporting healthy eating patterns. It is time to recognize that there is more influence on our food choices than education and will power alone. Other factors play a vital role in influencing food choices such as, personal relationships, where you live, work, and shop. Health professionals, industries, government, and communities are needed to support Americans and their families in making dietary and physical activity choices that align with the Dietary Guidelines. It is important to support local farmers, get involved to increase recreational access in your neighborhood, and foster partnership with food manufacturers to align more accessibility to recommended foods. Everyone plays a role in making healthy changes and in improving the health of the current and future generation. For more information on the dietary guidelines please visit

Special thanks to dietetic intern Amanda Cravinho for her contributions to this post.

Low-Fat vs. Low-Carb: Who Wins?

Agitated young woman looking up in frustration


As the end of 2015 approaches and the nutrition world anxiously awaits publication of the 2015 Dietary Guidelines for Americans, it’s worth taking a moment to consider where the world of research falls with regard to fad diets.

In the post-low-fat world that followed the 1990’s fat free and low-fat diet craze, you don’t hear much about a low fat diet anymore. The American Heart Association has moved off of recommending a “low fat” diet for heart disease prevention, and praise is now routinely heaped on the Mediterranean Diet – a relatively “high fat” (but the right type of fat!) eating pattern.

A study published last week in PLOS ONE did take a look at low-fat vs. low-carb diets and found that low-carb diets appear to be slightly better at lowing cardiovascular disease risk.

The meta-analysis looked at 1,797 obese or overweight people who were enrolled in 17 different studies. The overall weight loss was 17.6 pounds in the low-carb group and 13.2 pounds in the low-fat group.

To be fair, both of the groups showed a significant reduction in their 10-year cardiovascular disease risk score, but the study was funded by Atkins Nutritionals – the retail arm of the low-carb Atkins Diet.

The take away message is: when it comes to losing weight and cutting heart disease risk – calories do count. Eliminating added sugars, reducing white carb foods and cutting out excess amounts of bad fat have been shown to be effective ways to trim your waistline and your heart disease risk profile.

What’s Your State’s State of Obesity?

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The stats are in and the 2015 “State of Obesity” numbers are out. The State of Obesity – Better Policies for a Healthier America report is a project of the Trust for America’s Health and the Robert Wood Johnson Foundation.

This year’s 2015 report has published the following findings:

  • Rates of obesity exceed 35% in 3 states: Arkansas, West Virginia & Mississippi
  • All states have obesity that exceeds 20% of the population
  • Arkansas has the highest obesity rate at 35.9% and Colorado is the lowest at 21.3%
  • 17% of children and more than 30% of adults are considered obese

Although obesity rates appear to be stabilizing, they are still high. Overweight and obesity are linked to increased risk of chronic disease like heart disease, diabetes, stroke and certain types of cancer.

Obesity in adults is defined as a body mass index (BMI) of 30 or greater. BMI is a function of weight divided by height squared and you can calculate your own BMI using an online BMI calculator. For children aged 2-19, use the Pediatric BMI calculator which uses percentiles to determine obesity.

School Lunch Showdown: Pack or Purchase?

November 18, 2014 by  
Filed under Consumer awareness, Dietary Patterns, Fat


When it comes to school lunch, parents are faced with one of two choices: pack or purchase.

So which school lunch is healthier? The answer might surprise you.

A recent study published in the Journal of Nutrition Education and Behavior showed that when you pack a kid’s lunch, it is more likely to contain more fat, saturated fat and sugar.

Compare that to school lunches, which are higher in protein, fiber, vitamin A, and calcium.

This particular study looked at 1,314 school lunches: 562 of which were packed and 752 were school-purchased. The researchers found that packed lunches were generally less nutritious than those purchased at schools.

Nationwide, about 40% of American kids bring a packed lunch to school. For more information about the benefits of school nutrition, check out the USDA’s National School Lunch Program website at

If Polar Bears (and Eskimos) Can Eat a Very High-Fat Diet (and be healthy), Why Can’t I?

Many of us probably know that eating a very-high-fat diet will not only make us gain weight, but it will also increase our risk of heart disease. But surprisingly, there are 2 disparate population groups that, notably, consume very high quantities of dietary fats, yet have a very low incidence of cardiovascular disease, polar bears and traditional Alaskan Eskimos. How is that possible? Does it have to do with the types of fats they eat, or to specific physiological adaptations? The answer is yes, to both of these questions.

A recent study published in the highly touted scientific journal Cell (Polar Bear Study), showed that polar bears and brown bears diverged in evolutionary history less than 500,000 years ago. This is a surprisingly short time, in evolutionary terms. During this time, polar bears moved north, subsisted on a blubber-rich diet of primarily marine mammals and fish, and became profoundly obese. Interestingly though, these bears do not develop fatty deposits in blood vessels (atherosclerotic plaques) or suffer from cardiovascular diseases (CVDs) that afflict most humans with diets rich in fat. How can that be? The answer to this seemingly paradoxical question was revealed by the gene studies in this publication, and was discussed recently in Science Daily (Researcher Interviews). The researchers found that polar bears had evolved several gene variants that helped them adapt to the high-fat diet. These variants were in genes which related to fatty acid metabolism and cardiovascular function. The researchers concluded that this study may provide insight into how to protect humans from the ill effects of consuming too much dietary fat.

The second group mentioned above, arctic Eskimos called the Intuits, also eat high-fat diets and have traditionally had very low incidence of CVD. This has been referred to as the ‘Intuit Paradox’ (Discover Magazine). The Intuits historically ate a high-fat diet consisting of seal and walrus meat and other blubbery marine mammals. Although we don’t know about specific gene variants in this population relating to heart disease, we do know that the composition of fat they consumed is very different from fat consumed today by most Americans. The Intuit diet was traditionally high in mono- and polyunsaturated fatty acids (and protective omega-3 fatty acids), and low in saturated and trans fats. This seems rather unexpected since most of us know that animal fats are high in saturated fat. It had to do with the source of the fats. It turns out the wild-animal fats are different (less saturated fat; higher in monounsaturated fats, like in olive oil) from farm-animal fats and processed fats (which also contain damaging trans fats). Moreover, cold water fishes and marine animal fats are particularly rich in polyunsaturated fats and omega-3 fatty acids.

So this then leaves us with 3 options if we choose to consume lots of dietary fats and still want to be healthy: 1) hope that we rapidly evolve like the polar bears; 2) consume more fat from wild-caught animals; or 3) focus on fats derived from plant foods like seeds, nuts and whole grains. What will your choice be?

Not All Fish Are Created Equal

You have probably heard that we all should eat more fish and seafood, right? What you probably haven’t heard as much about is how the source and the type of fish you eat can influence not only nutrient intake levels but also the levels of certain contaminants you consume. This is a particular concern as some fish contain antibiotics, pesticides, or other chemicals, including mercury, polychlorinated biphenyls (PCBs) and dioxins. For some individuals, for example pregnant women, this is an issue of real importance as these substances can cause harm to the developing fetus.

Despite these potential risks, it is generally accepted in the nutrition community that fish is a healthy dietary choice and regular consumption can have a positive impact on overall health. For example, the American Heart Association recommends eating fatty fish at least two times a week (AHA Omega-3 FAs), and diets such as the Mediterranean and DASH diet also promote fish consumption. Certain fish (e.g. salmon) contain high levels of omega-3 fatty acids which have anti-inflammatory properties, and may decrease risk of heart arrhythmias and blood clotting, and thus be protective against heart disease. Fish is also high in protein yet low in saturated fats.

This then leaves us in a quandary. How are we to eat more fish and other seafood, yet avoid exposing ourselves to dangerous environmental contaminants? The answer lies in the type of fish we consume, whether it was farm raised or caught in the wild and the frequency with which we consume the fish. Let’s look at species first. Contaminants are most likely to be present in older, larger predatory fish, such as shark, swordfish, king Mackerel and tilefish (Mayo Clinic Fish Info). The U.S. Food and Drug Administration (FDA) thus recommends that young children and pregnant and lactating women avoid eating these fish. It is also important to keep in mind, that not all fish and other seafood are high in omega-3 fatty acids. Some however, contain significant levels of omega-3 fatty acids and also have lower levels of environmental contaminants. These include salmon, canned light tuna, shrimp, pollock and catfish, which then are the best choice for consumers.

Two other issues to consider are the source of the fish and whether taking fish oil supplements is a good alternative. As you may or may not know, many fish such as tilapia are raised in “fish farms”. These aquaculture facilities raise large numbers of fish in relatively tight quarters. This leads to an increase in the risk for infection and other illnesses; antibiotics are thus routinely used in this setting. It is also important to consider whether the fish was imported into the U.S. from another country, as the inspection process may not be so robust. Moreover, there is some evidence that the nutrient content of wild caught fish is higher, but the price may also be higher. And lastly, there is emerging evidence in the nutritional sciences world that fish oil supplements do NOT provide the same health benefits that regular consumption of certain fish.

In summary, eating fish is good for us, but we have to be educated to realize the greatest health benefits. This general rationale also applies to many other aspects of healthy eating, such as choosing fruits and vegetables with the lowest levels of contaminating pesticides. So, learn, procure, cook and enjoy!

(written with the creative assistance of Avery Bramnik and Nicole Solomon, both University of Florida undergraduate students)

Is saturated fat bad for your health?

March 27, 2014 by  
Filed under Fat, Heart disease

Welcome to the latest and greatest wrinkle in the world of nutrition science: a recent study has suggested that saturated fat – long considered a primary culprit in the development of heart disease – is perhaps no more than an innocent bystander. The meta-analysis, published March 18th in the Annals of Internal Medicine, found no association between saturated fat intake and increased risk of heart attacks or other cardiac events.

To be clear, the researchers did find a link between trans fat intake and heart disease. But they found no evidence that saturated fat increased the risk of heart disease, or that unsaturated fats decreased the risk of heart disease. Does this mean that you can now inhale steak, butter, and whole milk with abandon? Or stop taking those expensive flaxseed and/or fish oil supplements? Well, it depends.

On one hand, some folks believe that this study demonstrates a need to more specifically analyze individual types of saturated and unsaturated fats (e.g., some saturated dairy fats are associated with a lower risk of heart disease, whereas some unsaturated vegetable fats are associated with a higher risk of heart disease).

On the other hand, some folks believe that this study demonstrates a need to stop focusing on nutrients altogether and start focusing on whole foods. For instance, Dr. Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health who was not involved with the study at hand opined that “The single macronutrient approach is outdated. I think future dietary guidelines will put more and more emphasis on real food rather than giving an absolute upper limit or cutoff point for certain macronutrients.”

Food for thought

The whole food approach is nothing new. For instance, take a look back at Jamie’s October blog post about the Mediterranean Diet. Or, for a more lengthy review, read Michael Pollan’s essay, Unhappy Meals, that was originally published in the January 2007 edition of the New York Times Magazine. Pollan’s take-home message is definitely good food for thought: Eat food. Not too much. Mostly plants.

What do you think? Should saturated fat be avoided like the plague? Or is it more complicated than that?… Or perhaps more simple?

Health at Every Size?

November 27, 2013 by  
Filed under Fat

Being overweight or obese is often identified as the primary cause of heart disease, diabetes, cancer, and, ultimately, premature death. As a result, Americans are waging a war on fat (we have been for years). Diet books, pills, programs, and fitness fads abound… But is fat really at fault? Meaning, is an excess amount of body fat in and of itself responsible for the increased rates of death and disease? Or are other factors like unhealthy lifestyles, lack of cardiovascular fitness, and/or fat prejudice to blame?

Consider the concept of Health at Every Size (HAES). HAES is a relatively new “movement” focused on body acceptance and healthy lifestyles instead weight loss. From the HAES website: “Fighting fat hasn’t made the fat go away. And being thinner, even if we knew how to successfully accomplish it, will not necessarily make us healthier or happier… Health at Every Size is the new peace movement. Very simply, it acknowledges that good health can best be realized independent from considerations of size. It supports people—of all sizes—in addressing health directly by adopting healthy behaviors.”

It all sounds well and good, but is there any scientific support for HAES? Indeed, there is. A 2005 study published in the Journal of Academy of Nutrition and Dietetics compared the effectiveness of a traditional diet approach and a HAES approach in a group of obese women (the approaches were randomly assigned). It’s important to note that “effectiveness” in this study was not limited to body weight; outcome measures also included metabolic fitness (blood pressure, blood lipids), energy expenditure, eating behaviors (restraint, eating disorder pathology), and psychology (self-esteem, depression, body image).

The results? The attrition rate at six months was high in the diet group (41%) compared to the HAES group (8%). The diet group lost weight and showed initial improvement in many variables at 1 year, but the weight was regained and little improvement was sustained at two years. The HAES group, on the other hand, maintained weight, improved all other outcome variables, and sustained the improvements for at least two years.

Food for thought

Do you think people can be fat and healthy at the same time? How about fat and fit? Also, do you think the stigma and fear associated with being fat in the United States contributes to the current “obesity epidemic”?

Trans fats in the headlines (again)

November 8, 2013 by  
Filed under Consumer awareness, Fat

A few weeks ago I wrote a post about two different types of fats: “good” essential fats and “bad” trans fats. To be clear, I really don’t like using the terms “good” or “bad” when it comes to food because it’s rarely so black and white (see my first post It Depends). In this case, however, I’ll go out on a limb and call trans fats horrible! Apparently the U.S. Food and Drug Administration (FDA) agrees: “Condemning artificial trans fats as a threat to public health, the FDA announced Thursday it will require the food industry to phase them out” (Associated Press, 2013).

Trans fats are a health threat for at least three specific reasons. First, they raise “bad” LDL cholesterol levels (similar to saturated fats and dietary cholesterol). Second, trans fats lower “good” HDL cholesterol levels (which help clear LDL cholesterol from your arteries). Third, trans fats are associated with increased cellular inflammation (which contributes to high blood pressure among other things). Together these factors – high LDL, low HDL, inflammation – significantly increase the risk of cardiovascular disease, heart attacks, and strokes.

Where do trans fats come from?

Artificial trans fats are created via a process called hydrogenation, when hydrogen is added to liquid oils under high pressures and/or temperatures. Hydrogenation partially solidifies the oils, alters their mouthfeel, and increases their shelf life. Common food sources of trans fats include vegetable shortening, margarine, cookies, crackers, French fries, and other foods made with partially hydrogenated oils.

In 2006 the FDA began requiring manufacturers to list trans fats on food labels alongside saturated fats and dietary cholesterol. Trans fat intake subsequently declined among Americans from an average 4.6 grams per day in 2006 to about one gram a day in 2012 (Tavernise, 2013). That’s good news, but any amount of trans fats is too much and they can still be found in many processed foods like microwave popcorn, packaged baked goods, frozen pizzas, and coffee creamers.

Food for thought

From a health perspective, how many grams of trans fats do you consume each day? What types of foods could you substitute in place of trans fats? From a philosophical perspective, do you think the government should intervene in public health matters like this? Or should the choice to consume trans fats be left to consumers?


Associated Press (2013). “No More Trans Fat: FDA Banning the Artery-Clogger.” ABC News online. November 7. Accessed November 8, 2013.

Tavernise, Sabrina (2013). “F.D.A. Ruling Would All but Eliminate Trans Fats.” New York Times online. November 7. Accessed November 7, 2013.

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