Good Nutrition Made Even Easier

If there's one thing that's consistent in the field of nutrition, it's that information is always changing.  With the barrage of latest headlines about the scientific research on nutrition, how can we cut through the confusion and make healthy choices?  I usually spend a fair amount of time reading Nutrition Facts labels at the grocery store, weighing the pros and cons of each item.

Enter NuVal:  a user-friendly information system at the grocery store.  NuVal was developed by top nutrition researchers, led by David Katz, MD, of Yale.  It combines all the latest research about what makes a food healthy, and giving it a single numerical score from 1 (worst) to 100 (best).  The formula is complex, taking into account factors such as fiber, vitamins and minerals, sodium, calories, sugar, trans fats, and more -- but the end result is one simple number.

The best part of NuVal?  For grocery stores that choose to use it, it's right on the shelf, in black and white.  I first heard of this new system at a nutrition seminar last fall, and was surprised when I noticed the NuVal numbers on the shelf tags at Meijer a few weeks ago.  The numbers are small, so you have to squint a bit to read them, but they are there.  This is a very convenient way to compare foods in the same category, so you can quickly make better nutritional choices.

White pasta?

Or how about some whole grain pasta -- 30 points higher!

Yikes!  Just because a food is "organic" does not mean it's a healthy choice.

Of course, you still have to get a balanced diet of different types of healthy foods (ideally based around a Mediterranean-type pattern) -- you can't eat all asparagus all the time just because it has a NuVal of 100.  But if you can "trade up" to higher NuVal scores within the categories of foods you like, you'll notice the difference in your health.

Another Secret to a Smaller Waistline

There has been a lot of speculation about the increasing rates of obesity over the last few decades.  Many of the causes of this phenomenon are well known, and I have covered them in past articles: the move from whole foods to more processed foods, a decrease in physical activity with the rise in technology, and the increasing intake of both regular and diet soda pop.  One factor that often gets overlooked in this equation is the importance of a good night's sleep.

Researchers in the UK (1) recently published the results of a survey of over 100,000 women covering a 10 year period.  They found that light exposure at night disrupted the normal circadian rhythm (day-night cycle), and led to increased body mass index, and increased waist circumference.

If you are trying to shed pounds by increasing exercise, then bravo!  Just don't exercise late in the evening.  Night should be a time for winding down, decreasing activity, and definitely minimizing exposure to light (no falling asleep with the TV on).  The infographic below is a handy reminder of what's known as good sleep hygiene.  Use it to optimize your sleep, and maintain a healthier body weight.

1.  McFadden E et al.  The Relationship Between Obesity and Exposure to Light at Night.  Am J Epidemiol. 2014;180(3):245-250.

To Calcium or Not to Calcium?

Two big studies that came out recently have muddied the waters on the one nutritional supplement that even conventional medicine has rallied behind:  calcium.

We've all heard that supplemental calcium is good for the bones, and may even protect against colon cancer in older adults.  Seems like a logical recommendation.  But like hormone replacement therapy, whose cardiovascular benefits were disproven ten years ago by the Women's Health Initiative study, calcium supplements are now being called into question.

The first chink in the armor came a few weeks ago when a study sponsored by the National Institutes of Health (NIH) (1) found that supplemental calcium boosts the risk of death by cardiovascular disease (CVD) in men, but not women.  Men who consumed 1000 mg/day of calcium supplement had a 20% higher risk of CVD death than those who took no calcium.

OK, great... men, ditch the calcium; women, keep popping those ginormous horse pills.  Until February 13, when BMJ (British Medical Journal) (2) published the findings of Swedish scientists, who found that calcium supplements increased death rates in women, too.  Examining the findings more closely, though, we find some important details:  the all-cause mortality rates were doubled in women with a calcium intake of  more than 1400 mg/day, compared to those getting 600-1000 mg/day.  A further complication is that risk of death was increased if the calcium came from supplements rather than food.

The US Preventive Services Task Force (3) has also chimed in, with a re-analysis of older data that showed that 400 IU of vitamin D plus 1000 mg of calcium per day did not significantly prevent fractures in healthy older women.

These studies add more weight to hints that have been accumulating over the years, that just increasing calcium intake is not necessarily better for health.  Some cultures of the world have very low levels of calcium intake, but very little osteoporosis.  Meanwhile, the US recommendations for daily calcium have climbed over the years, so that now the RDA for women over age 50 is 1200 mg/day.  When it comes to bone health, just adding more calcium is like throwing more bricks on a construction site, and hoping that they'll form a building.  You also need an architect and foreman -- namely, vitamin D and vitamin K.

So how do we parse all this confusion about calcium, health, and disease for older adults?  Here's my bottom line:

• Men:  Keep your daily calcium intake under 1000 mg/day.  For most men, this means skipping the calcium supplements altogether.
• Women:  Ditch the high-dose calcium supplements that provide 1000-1500 mg/day.  Aim for that 600-1000 mg/day range total between dietary and supplemental calcium, with an emphasis on dietary sources (dairy, leafy greens, sardines).
• Men and women:  Get your blood tested for 25-hydroxyvitamin D on a regular basis; aim for a level between 40-80 ng/ml.  If it is low, you may safely take higher levels of supplemental vitamin D3 (consult your doctor for the right amount -- I usually recommend anywhere from 2,000-10,000 IU per day).  If you have CVD, osteoporosis, or risk factors for these conditions, be sure to get extra vitamin K along with vitamin D3.

Stay tuned; like all of nutritional science, the landscape and recommendations are constantly in flux.

1.  Xiao Q, Murphy RA, Houston DK, Harris TB, Chow WH, Park Y. Dietary and supplemental calcium intake and cardiovascular disease mortality. JAMA Intern Med 2013; DOI:10.1001/jamainternmed.2013.3283. 

2.  Long term calcium intake and rates of all cause and cardiovascular mortality: community based prospective longitudinal cohort study.  BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f228 (Published 13 February 2013)

3.  

Vitamin D and Calcium Supplementation to Prevent Fractures in Adults: U.S. Preventive Services Task Force Recommendation Statement.  Ann Intern Med. 26 February 2013