Ask the Dietitian: Questions from Albert Lea’s Women’s Health Care Symposium, February 2014
Answers provided by Amy Pleimling, registered dietitian
1.
How many grams of sugar should we consume in one day? In a 1,200 calorie diet?
This question is a hard one to answer because there are naturally occurring sugars and added sugars.
Most people who ask this question are referring to the added sugars. Naturally occurring sugars are
mainly from fruit (fructose) and milk (lactose) and those are healthy foods that should be consumed
multiple times daily. The American Heart Association recommends a limit of 6 teaspoons (24 grams) of
added sugar for women daily and a limit of 9 teaspoons (36 grams) for men daily. This is equivalent to
about 100 calories in sweets for women and 150 calories for men per day. An interesting fact is that the
average American consumes 21 teaspoons of added sugar per day (data from NHANES 2005-2006).
Here is a good article to read from the American Heart Association:
http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Sugar101_UCM_306024_Article.jsp
2.
What artificial sweetener is the best to use?
The decision to use artificial sweetener is a personal one. As a registered dietitian I do think use of
artificial sweeteners is proven to be safe in moderation and that they can fit into a healthy diet. The
artificial sweeteners available are approved by the FDA and it is the position of the Academy of Nutrition
and Dietetics that consumers can safely enjoy a range of sweeteners when consumed within an eating
plan that is guided by current nutrition recommendations, such as the Dietary Guidelines for Americans.
They are mainly used to reduce calories from sugar and can benefit people trying to cut calories and
people with diabetes who are controlling their carbohydrate intake. There are a number of them to
choose from with Splenda™ (sucralose) and aspartame being the most popular artificial sweeteners.
These seem to be well tolerated, are used in diet soda, flavored waters, light yogurts, light canned fruits
and many other places. If one was looking to stay away from these (either because of an allergy or a
personal belief) the natural (from a plant) non-calorie sweetener called Stevia™ is becoming quite
popular. Truvia™ is a name brand of the non-calorie sweetener that is made with stevia and is a good
option as well. Not as many products in the aisles are using these non-calorie natural sweeteners yet
and that is likely because of their cost. As with most dietitian recommendations – moderation is the key.
3.
I’ve heard aspartame is not very good for you. Is it worse than sugar?
See answer to the above two questions. Aspartame does get some bad press. My suggestion is to always
know where you are getting your nutrition information from; a registered dietitian, who went to school
for nutrition and practices in the field daily, is the most reliable source. Also, results of one study may
get media attention while 10 other studies proving the opposite side get no media attention at all. As
you can see from my answer in question 1 we are eating a lot of extra sugar in our diets which most
definitely contributes to extra calories and extra weight. I have no problem recommending artificial
sweeteners in moderation and do believe that sugar, no matter if it is from cane, beet, corn syrup, etc.,
needs to be controlled in our diets. As for aspartame specifically, average consumption even for the
highest users remains below what the FDA considers an acceptable daily intake (ADI). This is the
National Cancer Institute’s position on artificial sweeteners: “….there is no clear evidence that the nonnutritive sweeteners available commercially in the United States are associated with cancer risk in
human beings.”
4.
Aside from white flour, which flours are good for baking?
If you bake regularly it is a good goal to make your baked goods a bit healthier. You can certainly do this
by adding more whole grain flours into the recipe. Whole wheat flour can replace white flour but will
give a different texture/product. Some bakers like to at first try replacing ½ the flour in the recipe for
whole wheat flour. I am not a baker so I can’t really speak from experience here, but there are a lot of
whole grain flours to choose from and it will take some experimenting. There is whole grain white flour,
pastry flour, spelt, amaranth, teff, oat, corn, quinoa, rye, spelt and more. If you are interested in baking
with more whole grains, way to go! The nutrition in your product will be significantly improved! Here
are a couple resources for you:
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5.
King Arthur Flour Whole Grain Cookbook.
http://wholegrainscouncil.org/whole-grains-101/whole-grains-a-to-z
http://www.vegkitchen.com/tips/baking-with-whole-grain-flours/
What are your thoughts on coconut oil? Can you cook with it? Is it bad saturated fat?
Coconut oil is getting all kinds of media attention these days. You will find it refined and in virgin forms,
but either way it is extremely high in saturated fat (even more so than butter). One tablespoon contains
13.6 grams of fat and 11.8 grams of that is saturated. It does contain some antioxidant properties, but
mainly is getting its attention from the type of saturated fat that it contains – lauric acid, which is
classified as a medium-chain fatty acid. The “hype” surrounding coconut oil is mainly from claims of its
benefits on things from weight loss to Alzheimer’s disease. The truth is that there really isn’t enough
scientific evidence to support all of these claims. There is some preliminary evidence that this mediumchain type of saturated fat can raise both our HDL or “good” and our LDL or “bad” cholesterol –
suggesting a neutral effect on cholesterol levels. However, what we do know is that the American Heart
Association recommends limiting saturated fat to 7% of daily calories – that is 14 grams saturated fat
per day for an 1800 calorie diet. These guidelines have been established because saturated fats and
trans-fats increase total cholesterol and LDL or “bad” cholesterol. Bottom Line – skip foods that contain
partially hydrogenated coconut oil. If you choose to use coconut oil, use it in moderation and limit your
saturated fat intake overall.
Yes, you can cook with coconut oil. It has a sweet, nutty flavor. Virgin or unrefined is ideal for only a
medium –heat sauté or baking. The refined coconut oil is more stable to higher heat, so can be used in
baking or used in high-heat sautéing and stir frying.
6.
How do you pick an Omega 3 supplement? What would you look for on the label?
You are looking for the acronyms DHA and EPA in grams. Often times this is not what is on the front of
the bottle. Look on the label for the exact grams (or milligrams) provided per serving of EPA and DHA.
Here are the recommendations, taken directly from the American Heart Association website:
The American Heart Association recommends that consumers without documented coronary heart
disease (CHD) eat a variety of fish, preferably oily fish (salmon, tuna, mackerel, herring and trout), at
least twice a week. Consuming fish oil supplements should only be considered by people with heart
disease or high levels of triglycerides who consult with their physicians.
People with documented CHD are advised to consume about 1 gram per day of the fish oils EPA and
DHA (eicosapentaenoic and docosahexaenoic acids), preferably from oily fish, although EPA+DHA
supplements could be considered in consultation with their physicians.
People who have elevated triglycerides may need two to four grams of EPA and DHA per day provided
as capsules under a physician’s care. Very high intake (greater than three grams of EPA+DHA per day)
could theoretically cause excessive bleeding in some people.
7.
Is it okay to heat olive oil for cooking meats?
This topic can be very confusing. The important thing about cooking with any oil (olive or otherwise) is
not to heat the oil over its smoke point (also referred to as smoking point). The smoke point refers to
the temperature at which a cooking fat or oil begins to smoke (thus forming unhealthy compounds). But
what is the smoke point of olive oil? Depending on where you look for an answer, you may get vastly
different ideas. The smoke point will also depend on the type of olive oil and the processing that has
taken place.
The Olive Oil Source, believes that extra virgin olive oil smokes roughly between 365 and 400 degrees
(F). Here is what the International Olive Oil Council (IOOC) has to say about frying food with olive oil:
When heated, olive oil is the most stable fat, which means it stands up well to high frying temperatures.
Its high smoke point (410ºF or 210ºC) is well above the ideal temperature for frying food (356ºF or
180ºC). The digestibility of olive oil is not affected when it is heated, even when it is re-used several
times for frying.
A high smoke point is desirable for a cooking oil. When frying, the best results occur when the oil is very
hot. To put the above temperatures into perspective for you Irma Rombauer's The Joy of Cooking
recommends frying at 365ºF for best results.
Many other sources will say that the extra virgin olive oil (that is derived from the first pressing) is the
most delicate and of the olive oils has the lowest smoke point. The refined oils, like “olive oil” or “light”
in general will have a higher smoke point as they usually are a combination of refined olive oil and extra
virgin.
I think whether olive oil has a higher smoke points than other vegetable oils or not, with all of its health
benefits, it is a great choice for cooking as long as you are aware of the above and watch for that smoke
point. I found the following article to be most interesting on the topic:
http://www.oliveoilsource.com/page/heating-olive-oil
8.
Is lamb a good meat?
Lamb, like many other animal proteins can be lean but that depends on the cut. It is low in sodium, is a
great source of protein and a good source of iron.
9.
Why avoid diet carbonated drinks?
See answer to questions 2 and 3. Some choose to avoid diet drinks because of the artificial sweeteners
they contain. There is no solid research at this point that drinking diet pop leads you to crave more
sweets. Diet soda and water contains no calories and cannot make you gain actual body weight.
10.
Is it better to buy ground flax seed or grind it yourself? What about flax seed pills?
In my opinion it is always better to eat whole foods versus taking them in supplement form.
Supplements are not regulated by the FDA. Product labels can make claims on purity and other things
that may or may not be true depending on the company. Aiming for a healthy diet that is full of good
nutrition is better than taking the vitamins/minerals in a pill form.
As for grinding flax or buying it ground it is totally up to what fits your lifestyle best – they are the same
nutritionally. The main difference is in stability. Whole flax seeds are stable for up to a year in your
cupboard. You can grind them as needed. Once they are ground they need to be stored in an airtight,
opaque container in the refrigerator and are only good for 90 days.
11.
What is the difference between Greek yogurt and regular yogurt?
The main difference between the two nutritionally is that Greek yogurt has almost twice the protein of
regular yogurt. It also has more of the good bacteria that are so important in yogurt. Many people tell
me that the Greek yogurt is more satisfying and this is likely because of its higher protein content.
Greek yogurt is also much thicker and denser than regular yogurt. Because of this, it takes me a lot
longer to eat. Even though Greek yogurt gets most of the buzz right now, regular yogurt is still a great
choice for a snack or addition to a meal.
12.
What are Omega 6 and Omega 3? Is one better than another? Why?
Both are polyunsaturated fats and when eaten in the place of saturated or trans fats will be beneficial to
your heart. You hear much more about omega-3s likely because as Americans we seem to have an
easier time getting omega 6 fats in our diets over omega 3 fats. See the American Heart Association
explanation below:
Omega-3 fatty acids are essential fats that your body needs to function properly but does not make.
Humans must eat them through food, which means getting EPA (eicosapentaenoic acid) and DHA
(docosahexaenoic acid) from seafood, such as salmon, tuna, sardines, mackerel or shellfish, and ALA
(alpha-linolenic acid) from sources such as walnuts, flaxseed, and canola and soybean oils.
Omega-3 fatty acids, particularly EPA and DHA, have been shown to benefit the heart of healthy people,
and those at high risk for — or who already have — cardiovascular disease.
Omega-6 (n-6 polyunsaturated) fatty acids are the other group of essential fats that your body needs to
function properly but does not make. Hence, they need to be consumed in the diet.
Food sources of omega-6 fatty acids include some vegetable oils (soybean, safflower, sunflower or corn
oils), nuts and seeds. Increased consumption of omega-6 fatty acids in place of saturated fats and trans
fats is associated with a decreased risk of coronary heart disease.
13.
What about using Metamucil in your diet?
Metamucil is psyllium or a soluble fiber. It is used as a treatment for constipation or to promote
regularity. Since it is a soluble fiber, it can also be used as a way to add fiber to your diet to and to lower
your cholesterol. One adult serving has 3 grams of fiber. To be effective of course this would need to be
done along with a diet low in saturated and trans-fat. I often recommend that people increase the fiber
in their diets (as we generally fall short on the 35 grams per day that is recommended) for heart health.
Taking Metamucil (by following instructions on the bottle) is a way to help reach that goal. Drinking lots
of water is an important part of increasing your fiber intake.
14.
What about grape seed oil? How does it compare to olive oil?
Grape seed oil has a light flavor and is mainly made up of polyunsaturated fats. Olive oil is mainly
monounsaturated fat. In fact, the mono and the poly in the two oils are exactly reversed. When
discussing which is better, poly-or mono-unsaturated fats again both if used instead of saturated or
trans-fat will be beneficial. However, we know that the poly-unsaturated fats, while helping to decrease
our LDL or “bad” cholesterol, may also decrease our “good” or HDL cholesterol. While the monounsaturated fats help lower our LDL “bad” cholesterol and may leave our “good” HDL cholesterol alone.
So in that way, choosing an oil to keep on hand with that is high in mono-unsaturated fats (like olive or
canola) is a good way for us to get these good fats into our diet.
One other point about grape seed oil is that it is known for its high smoke point and thus is a good frying
oil option. (See question 7 for discussion on smoke points.)
15.
Does ethnicity affect how diets work?
If this question is referring to differences in health statistics by ethnicity, there are differences that are
researched and can be found at the National Center for Health Statistics at the CDC (Centers for Disease
Control). Ethnic differences in health vary across age groups, from one condition to the next, between
men and women, as well at between generations and geographic areas. As far as I know, a healthy diet
(low sodium for example) has generally the same positive effects no matter the ethnicity.
16.
What exactly is 100% whole grain bread? What does it mean?
The definition of a whole grain is as follows:
Whole grains or foods made from them contain all the essential parts and naturally-occurring
nutrients of the entire grain seed in their original proportions. If the grain has been processed
(e.g., cracked, crushed, rolled, extruded, and/or cooked), the food product should deliver the
same rich balance of nutrients that are found in the original grain seed.
This definition means that 100 percent of the original kernel – all of the bran, germ, and endosperm –
must be present to qualify as a whole grain.
In a store you can find whole grains – literally the whole grain. These are things like popcorn, oats,
millet, quinoa, buckwheat, barley, wild or brown rice and rye. There are whole grains of wheat, these
are not commonly known because we just say “whole wheat” but a few of those whole wheat grains
are: spelt, emmer, faro, durum, bulgur, wheat berries.
To make bread we follow a recipe. There are things in the recipe that are not grains of course. But to
call a product like bread “whole grain” it needs to contain 8 grams of whole grain per serving OR be 51%
whole grain by weight OR have whole grain as the first ingredient. In short, at least 50% of the grain
used in the recipe must be whole grain.
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17.
Where can you purchase the My Plate plates?
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18.
http://wholegrainscouncil.org/whole-grains-101/definition-of-whole-grains
http://wholegrainscouncil.org/whole-grains-101/existing-standards-for-whole-grains
www.learningzonexpress.com
www.superhealthykids.com
How do you choose the best fish oil supplement?
See answer to question 6 about what to look for in an omega-3 supplement and the recommendations
for omega-3 intake from the American Heart Association. In general, because supplements are not
regulated by the FDA, they are always something you should use with caution and especially in the case
of fish oil, consult your doctor before using (fish oil can be a blood thinner).
19.
What are your thoughts on all the diet supplements out there?
I am assuming by diet supplements this means supplements that are marketed towards making you
thinner or helping you speed the process of weight loss. As much as I am for our country becoming
healthier by losing weight, I think that this category of supplements should be used with extreme
caution. The efficacy and safety of these products is not known (well some of them in the past have
proven to be unsafe actually), nor are their benefits proven in research. Again, supplements are not
regulated by the FDA. Weight loss products are a multi-billion dollar industry and can be very expensive.
Weight loss is not a quick fix and anything promising that is likely to be too good to be true.
20.
Which is better for you: butter or margarine? What about lard?
This is a very popular question for the dietitian. The better of the two has been a battle for years. The
argument was once saturated fat versus trans- fat. We know that saturated fat is a fat that when eaten
in abundance raises our LDL or “bad” cholesterol and causes plaque. Margarine used to contain transfats which have proven to be harmful to our hearth health as well – even more so than saturated fat.
Trans-fats come mainly from the process of hydrogenation. These days it is actually pretty hard to find
trans-fats in the margarine section. You can still find it in the cheaper sticks of margarine – so avoiding
these is a good idea. Margarine in a tub that has a higher content of monounsaturated fats and no transfats is probably the best option for heart health (and is easy to find). If a person is concerned about
“natural” ingredients, there are margarine products using all natural ingredients and this information
can be found on the label. Butter and lard are both “natural” products but each tablespoon has five to
seven grams of saturated fat- which is about half of the recommended amount daily for heart health.
To use butter healthfully would mean to control or limit other sources of saturated fat and would
obviously depend on the amounts of other saturated fats in your day (i.e. from meat, snack foods, etc.).