Seniors Making Informed Nutrition Choices with 42,686 Choices

Dr. Cary Kreutzer, EdD, MPH, RD

“Eat foods, not too much, mostly plants” “Eat only foods that will rot”“Try not to eat alone” “Do all your eating at a table”“Cook”

Michael Pollan, Food Rules, 2009

Nutrition Research• New research overwhelming to sort through, what comes through in media

may be biased• With 42,686 food items in the average grocery store (2012, Food Marketing

Institute) the choices are overwhelming• Marketing and advertisement may lead us astray with significant

advertisement budgets • Food claims are powerful – endorsed by celebrities – everywhere we look• Complementary and alternative medicine & vitamin/mineral

supplementation is commonplace • Consumers have to be savvy and do their research

Three Themes 1. Evaluating evidence to support or dismiss

nutrition claims2. Finding iPhone, Android APPs and Webpage

reliable nutrition resources 3. Subscribing to reliable and evidence-based

nutrition information resources to keep informed

1. Finding the Evidence to Support or Dismiss Nutrition

and Health Claims

Vitamins, Minerals & Supplements• In 2011 around 53% of American adults used some type of

supplement in the years 2003 to 2006 (NCHS)• Multivitamin/multi-mineral formulation were the most popular

(NCHS). • U.S. Consumers spent $28 billion on supplements in 2010 • In 2013 an analysis of 27 studies was conducted on over 450,000

adults, for the U.S. Preventive Services Task Force. The Study found “no consistent evidence that supplements prevent or delay progression of cardiovascular disease, cancer, or other cause of mortality in healthy individuals without known nutritional deficiencies.

2011 report from the National Center for Health Statistics (NCHS)2013, Guallar, E., Ann. Inter. Med.

Evaluating Evidence • Credentials of researchers• Academic Institution of researchers• Number of participants and demographics• Study design and scope of intervention• Rigor of the study- double-blind placebo vs.

convenience sample

Evaluating nutrition product information“Shop this look: The weight loss drink stars love”

Example: David Kirsch’s Thermo Bubbles

“Ever wish there was a drinkable potion that would naturally increase your energy and make you look better? Beauty expert Mikaela South unearthed this miracle potion capable of reducing bloating and puffiness and even helping you lose a few pounds”.

David Kirsch

• Designed by Wellness Expert David Kirsch, this patented blend of vitamins and antioxidants naturally stabilizes your energy while putting your metabolism in motion to lose a few extra pounds.

• Sugar-free, low-calorie delicious carbonated drink that both boosts energy and ramps up your metabolism

• Promotes calorie and fat-burning, and smashes cravings without bloating, jitters, or a caffeine-crash

• Loaded with antioxidants including green tea, white tea, guarana and ginseng, along with two proprietary vitamin, herb and mineral blends

• Includes 10 tubes, 0.4 oz. each for $ 40.00; $ 4.00 per single serving

David Kirsch• “a former lawyer who turned his life over to exercise and nutrition, and

wants New Yorkers to do the same” (Well and Good NYC)• The NY Ultimate Body Plan (Book). Book review: “Being a personal trainer, I

had mixed emotions from this book. I understand David's principle and whether anyone wants to admit it or not, this is a tough 2 week quick fix program. No one could continue to live on this program which thankfully David makes clear. But folks, this is nothing new. It is the Zone Diet with 1 1/2 hours of cardio a day for 2 weeks”.

Ref: http://www.wellandgoodnyc.com/2011/03/03/david-kirsch-uncovered-the-man-and-the-plan-behind-the-models

How to Read The Label? Serving size: the

package may contain more than 1 serving

Calories: (energy) amount of calories in 1 serving

Fat: 5% or less is low, 20% or more is high

Carbohydrate: fiber and sugar

Vitamins and minerals

Thermo Bubbles Ingredients

Partial list from highest concentration to lowest• Inositol• L-Arginine• Guarana• L-ornithine HCL• Picolinate• Phosphatidylcholines

Inositol

• Inositol is found in fruits, and is a carbohydrate having half the sweetness of table sugar. Is often used as a cutting agent and sweetener because it dissolves easily.

• High dose (12 grams/day) have been tested in reducing panic disorders and depression (Palanic, 2001; Levine, 1995)

L-Arginine• Arginine is an amino acid normally made by the body. Arginine is also found in many

foods that have protein.• In general, most people do not need to take arginine supplements because the body

usually produces significant amounts in healthy individuals.• Arginine becomes nitric oxide (a blood vessel-widening agent called a vasodilator) in

the body. Early evidence suggests that arginine may help treat medical conditions that improve with increased vasodilation.

• Arginine also triggers the body to make protein and has been studied for healing wounds, bodybuilding, enhancing sperm production, and preventing tissue wasting in people with critical illnesses. Arginine was associated with death in some people with heart conditions

http://www.mayoclinic.org/drugs-supplements/arginine/background/hrb-20058733

Guarana• Guarana is a plant named for the Guarani tribe in the Amazon, who used the seeds to

brew a drink. Today, guarana seeds are still used as medicine.• Guarana is used for weight loss, to enhance athletic performance, as a stimulant, and

to reduce mental and physical fatigue and is a frequent addition to energy and weight loss products.

• Some people also use Guarana to treat low blood pressure, chronic fatigue. It is also used to enhance sexual desire, to increase urine flow, and as an astringent.

• In food manufacturing, guarana has been used as a flavoring ingredient in beverages and candy.

• Guarana contains caffeine. Caffeine stimulates the central nervous system, heart, and muscles.

• Guarana also contains theophylline and theobromine, which are chemicals similar to caffeine.

L-ornithine HCl & Picolinate• L-ornithine is an amino acid (protein) that plays a role in the urea cycle.• L-Ornithine supplementation research has suggested that L-ornithine has an anti-fatigue

effect in increasing the efficiency of energy consumption and promoting the excretion of ammonia.

• Chromium picolinate is a chemical compound sold as a nutritional supplement to prevent or treat chromium deficiency. Small quantities of chromium are needed for glucose utilization by insulin in normal health, but deficiency is extremely rare and has only been observed in hospital patients on long-term defined diets.

• No biochemical basis for the human body's need for chromium has been identified.• Chromium picolinate has been described as a "poor choice as a nutritional supplement".• It may be the bright red color is useful in giving “Thermo Bubbles” a rose color.

http://en.wikipedia.org/wiki/Chromium%28III%29_picolinate

•, S; Yamada, T; Yamaji, S; Komatsu, M; Morishita, K (2010). "The effect of L-ornithine hydrochloride ingestion on performance during incremental exhaustive ergometer bicycle exercise and ammonia metabolism during and after exercise". European journal of clinical nutrition 64 (10): 1166–71

Critically review product claims and ingredients label

• Read the food label, ingredients are listed in order of concentration• Be skeptical about claims on the label, if it sounds too good to be true… it likely is too

good to be true • Speak with your Primary Care Physician ask about the evidence • Use reliable internet resources to find answers

– Wikipedia to narrow your search– Google Scholar using a key word search– American Medical Association– National Institutes of Health; National Center for Complementary and Alternative

Medicine

2. Selecting APPs & Web Info• Is the APP available on multiple devices and across devices • Setting-up APPs – most will ask if it is OK to know your phone location. Most will ask if

you will allow Push information – the APP will ask for an email address to provide additional information. You can say yes and then change your configuration for the APP in your settings on your phone or I-PAD.

• Many of the APPs allow you to share your information on other social media sites, e.g., Facebook.

• Some APPs allow you to look at your data on your computer and on your Phone, you may be able to send information from your computer to you phone or sink data from both to match.

Paying for APPs• Many APPs are free• Some APPs have introductory information that is free and charge for

additional applications and features• Start with the introductory resources before purchasing additional resources• If you download an APP that you no longer want be sure to delete from your

phone or computer• APPs will use data, look closely at your plan provider allowance for data use• If you are using WiFi you do not get charged by your plan provider for data

Nutrition APPs review

Academy of Nutrition and Dieteticshttp://www.eatright.org/appreviews

• Diabetes – Vree for Diabetes• Gluten Free • Weight Management – My Fitness Pal

Waterin

• Free; iPhone, iPod, iPad• Water app that tracks the

amount of water you drink and even reminds you to drink water

Grocery Gadget• Grocery Gadgets allow you to easily organize grocery lists, coupons, recipes

on FREE Web portal and on your mobile device.• Lite version Free, deluxe 4.99• Webportal, Android, iOS, Blackberry, Windows Phone, Nokia, Amazon Nook

WebMD• Free – on your phone or Computer • WebMD contains listings for healthcare professionals

and pharmacies in your area, as well as first-aid guides—simple instructions for dealing with an emergency that everyone should have accessible to them at any time. The APP also provides information on evidence-based diets, The DASH DIET

My Fitness Pal

• Free; iPhone, iPad, online • The free fitness app MyFitnessPal is all-in-

one calorie counter and exercise trackers for the iPhone. A simple design and interface make using the APP quick and easy. Includes an exhaustive food and nutrition database.

My Plate

• Web-based applications

• Available on I-tunes as an APP

www.ChooseMyPlate.gov• The website has practical information and tips to help

Americans build healthier diets. Super-tracker allows diet tracking and calorie counting.

• It has selected messages to help consumer focus on food behaviors. Messages include:

o Balancing Calories o Foods to Increase o Foods to Reduce

• You can develop your own food plan• You can find recipes

3. Web Resources - Evidence-Based Nutrition

• Medline Plus, http://www.nlm.nih.gov/medlineplus• Science Daily http://www.sciencedaily.com• AICR Science Now, www.aicr.org• American Heart Association Nutrition Center, http://www.heart.org• Academy of Nutrition & Dietetics www.eatright.org• WebMD, Find a Vitamin or Supplement, www.webmd.com• Diet Supplements Adverse Events, http://www.safetyreporting.hhs.gov• Center for Science in the Public Interest, https://www.cspinet.org

Take Control - Strategies• Maintain weight at a healthy level • Eat a balanced diet fruits and vegetables

Mediterranean diet 46% greater odds of healthy aging*• Decrease stress – improved awareness of at-risk

behaviors – change behaviors• Decrease intake of processed foods FAT, SUGAR, SALT• Regular medical visits with Physician - screening – talk about

health and diet – make a plan – small steps including adequate sleep + exercise

• Samieri, Sun, Townsend, et.al., 2013 , Annals of Internal Medicine (women mean age 59 years, followed 15 years)• US News and World Report ranked the Mediterranean Diet and the #1 diet for health and weight loss 2013